One Doc Flashcards
Complications associated with 12mm overjet, well aligned arches and ectopic canines.
Trauma risk to anterior teeth, difficulty speaking, eating, psychological factors ie teasing, root resorption of adjacent teeth.
Dental complications of a retainer
Fixed - can debond, wire can fracture, difficult to keep clean, higher gingivitis risk.
Removable - thermoplastic - can be lost, can later occlusion, chip or fracture, compliance.
Posterior cross bite URA appliance design
Aim: Correct posterior cross bite.
A - Midline palatial screw.
R - Adams clasps on 4’s and 6’s.
A - Yes.
B - self cured PMMA and posterior bite plane.
What does right deviation of mandible on closing mean and what are the 2 problems associated if untreated
Mandibular displacement on closing due to inter-arch width discrepancy - due to inter-arch width discrepancy, the teeth naturally occlude in such a way that the posterior teeth are cusp to cusp, and therefore the patient needs to deviate their mandible to a side to achieve intercuspation.
TMD, parafunctional habit, toothwear.
Name 4 fluoride supplements that could be given to a patient with a fixed appliance.
Toothpaste - 1450 ppm.
Fluoride varnish - 22600 ppm 4 times per year.
Fluoride mouthwash - 225 ppm once daily.
Fluoride tablets - 1mg once daily.
2 methods to prevent decalcification other than fluoride supplements
OHI and diet advice, fissure sealants.
List 8 potential risks of orthodontic treatment other than decalcification
Root resorption, relapse, gingival recession, failure to complete, wear of adjacent teeth, ulceration, loss of vitality, mucosal irritation, loss of periodontal support.
How do you assess a patients AP relationship?
Visual, palpate skeletal bases, lateral cephalometric.
4 special investigations an orthodontic specialist would do
Study casts, clinical photographs, lateral cephalometric, OPT
4 intra-oral features of a class III patient
Reverse or reduced OJ, displacement on closure, retroclined lowers, attrition.
What systemic condition is associated with a class III patient in which the mandible keeps growing?
Acromegaly.
Design a URA to correct a 12 cross bite
Aim - please construct a URA to correct the anterior crossbite of tooth 12.
A - Palatal z-spring on 12 - 0.5mm HSSW.
R - Adams clasps on 4’s and 6’s - 0.7mm HSSW.
A - Yes.
B - Self cured PMMA, posterior bite plane.
What 4 characteristics of the dentition 12 anterior crossbite make this ideal for URA treatment?
Enough space, 12 palatally tipped, good OB for stability, only 1 tooth movement required.
What 5 factors can resist displacement forces?
Gravity, mastication, active component, speech, tongue.
Information to include in a referral to an orthodontist
Pt details - name, age, history, radiographs, photographs, skeletal base, incisors class.
Management of a debonded bracket and demineralisation
Account for components, ask the pt if they know what happened, check the health of teeth, deal with problem - if arch wire circular, remove ligature and bracket, if archive square, ensure ligature attached tightly and teach pt to move bracket to side to clean, refer back to ortho, inform pt of decalcification.
Non-compliant patient - option of extraction of incisors and denture provision
Loss of incisors - drifting of incisors, resorption of bone, labial profile.
Denture - plaque retentive factor, increased perio risk, aesthetic, psychological.
Uncompliant patient - why are crowns not indicated?
Destructive crown prep, OH not satisfactory enough.
OHI in high risk pt
5000ppm toothpaste, ID cleaning, disclosing tablets, spit do not rinse, 2 mins, modified bass technique, 2x daily.
What are the uses of a URA
Tooth tipping, habit breaker, space maintainer, reduce OB, expand arch, retainer.
Design a URA to reduce 8mmOJ and OB - 4’s missing
Aim: Please construct a URA to reduce the OJ and OB.
A - 22, 21, 11, 12 - roberts retractor - 0.5mm HSSW and o.5mm ID tubing. 13 + 23 mesial stops - 0.7mm flattened HSSW.
R - 16 and 26 - Adams clasps - 0.7mm HSSW.
A - moving 4 teeth - not ideal, but okay.
B - Self cure PMMA - FABP - OJ+3mm.
Anchorage for arch widening
Reciprocal anchorage.
Give 6 bits of advice when delivering a URA
Worn 24/7 including mealtimes, will be uncomfortable, increased saliva, bulky, speech difficulties, brush dry toothbrush after meals, remove and store safely when playing contact sports, avoid fussy drinks, hot and sticky foods, give emergency contact details.
Outline the delivery of a URA
Check correct pt and appliance, appliance matches design, feel for sharp edges, check integrity of wire work, insert and check for blanching of tissues or trauma, inspect posterior retention, flyover then arrowheads, check anterior retention, activate, show pt insertion and removal and get them to do it, review in 4-6 weeks.